Resistance to care (RTC) is a common abnormal behavioral manifestation of behavioral and psychological symptoms of dementia. Although RTC is strongly associated with agitation or aggressive behavior, it is a specific behavioral response of dementia patients to caregivers, and may result in a negative feedback mechanism as it often directly, negatively impacts caregivers. Currently, there are rare studies on RTC in dementia patients or measuring RTC in these patients using relevant tools in China, which may be because domestic researchers easily confuse RTC with other behavioral concepts. While the concept of RTC was introduced earlier in foreign studies, and has been systematically explored and studied. In this paper, we reviewed available relevant studies, and gave a detailed description of the concept, impact, assessment tools, and interventions regarding RTC, with a view to providing ideas and strategies for the study of RTC in patients with dementia in China.
Resistiveness to care (RTC) is a common abnormal behavioral symptom in dementia patients during the care process, which seriously negatively impacts the patients and their caregivers. The research on assessment tools for RTC started earlier in foreign countries, and has explored relevant aspects more deeply and comprehensively. Since the Resistiveness to Care Scale for Dementia of the Alzheimer's Type (RTC-DAT) came out in 1999, overseas researchers have made several revisions to its content and methods, and have expanded it to include different scales for assessing RTC in different care settings. In this paper, we present a review of the tools developed overseas to assess RTC in patients with dementia, focusing on the differences in contents and methods of the tools, and the characteristics, strengths and weaknesses of each tool, which may offer insights into China's development of such a tool or introduction of a foreign tool applicable to China. The evaluation method of the assessment tools currently used in foreign research on RTC in patients with dementia is mostly based on the researcher-observed method used in the initial RTC-DAT, which faces many limitations in its practical application. The Refusal of Care Informant Scale (RoCIS) developed in 2022 attempts to use the method of evaluation by consulting caregivers, which is commonly used in other fields, providing a new way for China's introduction or development of a RTC assessment tool applicable to Chinese dementia patients. Considering various types of these tools, we recommend that the tool should be selected according to its applicability assessed comprehensively.
Among cancer survivors who are characterized by poorprognosis and quality of life, there is a high prevalence of sedentary behavior, which is closely associated with adverse outcomes, requiring urgent attention. Based on this, we reviewed the latest advances in sedentary behavior among cancer survivors, including relevant theories, assessment methods, influencing factors, association with prognosis and intervention, and concluded that sedentary behavior that sedentary behavior is a major risk factor for poor prognosis in cancer survivors, and single physical activity intervention or a combined intervention of physical activity and sedentary behavior is effective intervention. Additionally, given the situation where there is an urgent need to manage sedentary behavior in this group, indigenized studies ought to be carried out actively to make some improvements in their prognosis.
Colorectal cancer (CRC) is one of the most common tumors in the world. Colorectal polyps are local protuberant lesions that elevate the intestinal mucosa, and about 90% of CRC is evolved from polyp. According to the traditional concept, the occurrence and development of CRC is mostly through the "adenoma-cancer" sequence. However, studies have found that serrated polyps also form subclasses with different morphology and genes, and are closely related to microsatellite unstable CRC. About 15%-30% of CRC develops through the "serrated polyp-cancer" pathway. This article mainly reviewed the clinical characteristics of colorectal adenoma, serrated polyp and post-inflammatory polyps, through retrospective analysis of large samples, to summarize the incidence of different pathological types of colorectal polyps in the progression of carcinogenesis and the follow-up monitoring after polypectomy, so as to provide a better reference for follow-up monitoring of polyp patients and early screening and treatment of precancerous lesions.
Chronic diseases have become a major problem affecting the health of residents in China and globally. The improvement of the quality of general practice is of great significance to improving the management of chronic diseases in primary care. It is an important way to achieve continuous quality improvement by evaluating the quality of chronic disease management in general practice to identify the current problems. According to the review of current status of domestic and international research, some countries have established relatively complete quality evaluation systems for the management of chronic diseases in general practice. Compared with foreign countries, the practice of quality evaluation and improvement of chronic disease management in general practice in China is still in the exploratory stage, although some progress has been made, there are also some challenges: firstly, the quality evaluation of chronic disease management is mainly focused on hypertension and diabetes, insufficient attention has been paid to the clinical quality of other chronic diseases, and the degree of refinement of clinical indicators still needs to be further strengthened compared with foreign countries. Secondly, there are limitations in evaluating the practice process of chronic disease management in general practice, most of the researches were mainly limited to the performance indicators within the framework of services specification. It is possible to refine the evidence-based quality evaluation and quality improvement systems and specify monitoring indicators. Thirdly, there is still a big gap in the construction of information system in general practice, the "fragmentation" and lack of information have seriously hindered the effective evaluation of the quality of chronic disease management, the information system construction should be improved as soon as possible. Fourthly, quality evaluation results focus on feedback within the administrative system and health service providers lack awareness of their own service quality, more equitable and effective evaluation and feedback mechanisms should be explored to promote continuous improvement in the quality of chronic disease management.
As China enters an ageing society, the number of elderly people is rising sharply, resulting in a continuous increase in the cost and burden of caring for the elderly. Frailty is an important cause of loss of self-care ability and elderly care problems in elderly people, which means that frailty is associated with a decline not only in physiological functions, but in multiple areas as well, such as mental ability and socioeconomic functioning, and is considered an important geriatric syndrome that affects the quality of life of the elderly. Comprehensive Geriatric Assessment (CGA) is a multi-dimensional and multi-disciplinary assessment process or model specifically for elderly patients. As a core tool in geriatric medicine, it uses a multi-dimensional and multi-disciplinary approach to assess the physical condition, functional status, mental health and social environment status of the elderly, and accordingly a treatment plan is developed to maintain and improve the functional status of the elderly and enhance their quality of life to the most extent. However, the use of CGA is not entirely consistent in China and abroad. This paper reviews the existing studies on frailty in the elderly, analyses the advantages and shortcomings of CGA used in frail elderly patients, and finds that interventions for frail patients at home and abroad have been valued increasingly. The development of domestic interventional studies on frailty is still in the initial stage, and most of these studies use a design of a randomized controlled trial with a sample of chronic disease inpatients. In contrast, such studies have been widely carried out abroad, in which CGA has been applied to the management of cancer patients and patients in the perioperative period besides chronic disease patients and frail community-dwelling older people. The frailty status in the elderly can be scientifically and comprehensively assessed by the CGA, and based on which targeted interventions can be implemented to prevent or delay the development of frailty, but it is generally time-consuming, and there are many difficulties in the management of the assessment recipients. In the future, it is necessary to advance the clinical application of CGA, or develop a more rapid, comprehensive and authoritative tool based on CGA for frailty assessment in the elderly, so as to provide comprehensive and personalized medical services and health guidance for frail elderly population through standardised assessment.
The incidence of hearing loss among the elderly is increasing along with the acceleration of global aging. Hearing loss can limit the ability of the elderly to monitor and perceive auditory cues for spatial orientation, resulting in confusion of orientation and increasing the risk of falls. Based on the review of the latest relevant studies, we introduced the epidemiological characteristics of falls in the elderly with hearing loss, described the pathogenesis (including neuropathological mechanism, sensory deprivation mechanism and physical mechanism), summarized the influencing factors (including age, gender, degree of hearing loss, nature of hearing loss, gait performance, and the use of hearing aids), and put forward strategies for the prevention and treatment of falls. We found that the incidence of falls is increasing in the elderly with hearing loss, and its risk grows with the aggravation of hearing loss, age, aging-related hormonal changes (especially in elderly women), the decline in balancing ability and negative emotions. To reduce the incidence of falls to ensure quality of life and safety in elderly people with hearing loss, it is suggested to prevent or treat falls in this group by the use of hearing aids and auditory rehabilitation training, drug therapy, balance assessment and physical exercise, and psychological intervention.
Acute-on-chronic liver failure (ACLF) is a severe acute liver function decompensation that occurs after an acute attack on the basis of chronic liver disease, which has attracted the attention of hepatologists worldwide due to its rapid progression and sky-high short-term mortality. As the etiology and clinical features of ACLF significantly differ across various countries/regions, there are at least ten diagnostic criteria for ACLF at home and abroad. Therefore, in this paper, we reviewed the studies related to several commonly used definitions and diagnostic criteria of ACLF, and compared the differences among the diagnostic criteria, so as to help clinicians better identify ACLF and optimize clinical decision-making, thereby improving the clinical outcomes of ACLF patients. As there are still no recognized criteria for the diagnosis of ACLF worldwide, and large variations exist between the diagnostic criteria of ACLF at home and abroad, clinicians should select the diagnostic criteria for ACLF with sufficient consideration of etiology of chronic liver disease, clinical characteristics and other factors of patients.
Chronic obstructive pulmonary disease (COPD) is a global public health problem with increasing incidence and mortality. Fatigue is a common complaint of COPD patients, which seriously impairs the quality of life.
To conduct a scoping review of current research status and tools about fatigue as well as fatigue-related factors in COPD, providing ideas for the development of relevant individualized intervention schemes.
Methodological framework was used. Studies on fatigue in COPD were searched from databases of Web of Science, PubMed, EmBase, CINAHL, ProQuest, the Cochrane Library, CNKI, WanFang, CQVIP, and SinoMed from inception to July 2022, and enrolled according to the inclusion and exclusion criteria. Relevant data were extracted, collected, summarized and reported.
A total of 52 studies were included. Taken overall, a wide variety of assessment tools for fatigue in COPD featured by lack of multidimensionality and specificity were used, among which common were the Functional Assessment of Chronic Illness Therapy and the Fatigue Severity Scale. There were certain disparities in the incidence, duration, and severity of fatigue in COPD across studies. The main influencing factors of fatigue include sociodemographic factors, COPD-related factors, somatic factors, and psychological factors.
As fatigue is a major symptom that seriously declines the quality of life in COPD patients, clinical care providers need to use specific tools to accurately assess fatigue, and to develop individualized interventions to improve fatigue according to its influencing factors.
Atrial fibrillation (AF) is one of common clinical arrhythmias, among which asymptomatic AF is insidious, poorly understood, and prone to adverse outcomes, bringing a serious burden to patients. As disease screening is a measure that should be implemented prior to the prevention of disease-related complications, it is crucial to carry out asymptomatic AF screening and scientific management. Current hot issues in screening for AF include the selection of the most appropriate screening population, the selection of screening devices and modalities, the improvement of screening participation, standard indications of anticoagulation therapy for those diagnosd, and the evaluation of the best economic screening option. We included twenty-five articles related to screening for atrial fibrillation, and systematically reviewed the AF screening section in AF management guidelines published in recent five years and opinions of relevant experts, then gave a summary of the latest advances in AF screening, involving screening strategies, screening devices, screening participation, anticoagulation treatment participation and monitoring duration and monitoring modalities in post-stroke screening, and the association of screening strategies on cost-effectiveness of the screening analyzed using a perspective in health economics, as well as economic impact of patient participation in screening and anticoagulation treatment. All these are beneficial to the guidance for clinical practice. The more internationally recognised guidelines for the screening and management of atrial fibrillation are the European Heart Rhythm Society guidelines and the North American Heart Rhythm Society guidelines. Most studies on the cost-effectiveness of AF screening have used Markov models for lifetime simulation. Health economics analyses include stroke events, bleeding events, quality-adjusted life year (QALY) , and incremental cost-effectiveness ratio (ICER) . Most guidelines recommend routine screening with newer devices, such as portable single-lead ECGs in high-risk groups aged 65-75 years, to facilitate continuous monitoring and improve AF detection rates; for post-stroke screening, national and international guidelines emphasize screening for AF in patients with cryptogenic transient ischemic attacks (TIA) /stroke, with the main focus on Long-range ECG and implantation of an insertable cardiac monitor (ICM) . In summary, although some progress has been made in understanding the cost-effectiveness of AF screening, many differences still need to be fitted, and the health economics of AF screening are poorly understood in China. This will provide an evidence-based basis for improving life expectancy and quality of life and reducing the economic burden of healthcare.
Atrial fibrillation (AF) is one of the two major bastions that need to be tackled in cardiovascular disease field. The rates of AF screening and standardized management are low, which are mainly due to the limitation of "no onset symptoms of AF at the time of detection and no detection at the time of having onset symptoms of AF" in the traditional screening. Wearable devices are technologies that can facilitate early detection and scientific management of AF, whose applicability, sensitivity and specificity in the screening AF have been gradually verified. We reviewed the latest developments in wearable devices for AF screening and management, including epidemiological characteristics of AF, and current application, applicable limitations and prospect of wearable devices, providing a theoretical basis for the use of wearable devices in the screening and management of AF.
Oral frailty has been recently suggested as a novel construct defined as a decrease in oral function with a coexisting decline in cognitive and physical functions, which is associated with many adverse events in older adults, such as frailty, sarcopenia, disability, and mortality. We reviewed the definition, symptoms, diagnosis criteria, assessment tools of oral frailty in older people, and summarized its recent research status as well as possible influencing factors, then suggested that future research on oral frailty in older Chinese adults could be carried out in aspects involving developing oral frailty assessment tools appropriate for older Chinese people, implementing survey studies on oral frailty, enriching study designs and contents and enhancing oral frailty intervention studies.
Hyperkalemia is a common clinical problem, and risk factors for its occurrence include having kidney disease, cardiovascular disease, diabetes, and taking medications that affect serum potassium. Mainly presenting with cardiac and neuromuscular symptoms, it can also lead to serious cardiac arrhythmias. Therapeutically, the choice of drug or dialysis treatment should be guided by the serum potassium level and the severity of clinical manifestations. Multiple novel oral potassium lowering drugs have emerged in recent years, promising to change the treatment paradigm of hyperkalaemia. In this paper, the epidemiology, diagnosis, cause, prevention, and treatment of hyperkalemia associated with comorbid risk factors were reviewed in combination with the literature, in order to provide a theoretical basis for the related diagnosis and treatment of hyperkalemia associated with combined risk factors.
China is seeing an increasing prevalence of inflammatory bowel disease (IBD) . During the process of exploring treatments for IBD, gut microbiota has been found to be crucial to the development of IBD along with the discovery of microbial-host interactions, suggesting that modulating gut microbiota may be a new strategy for the treatment of IBD. Recent studies have shown that Lactobacillus rhamnosus GG (LGG) , one most widely used probiotic strain, can achieve IBD alleviation by regulating intestinal microbial composition, maintaining intestinal epithelial barrier integrity, modulating intestinal immune response, inhibiting oxidative stress, and improving anxiety-depression status. Therefore, this paper presents a review of the mechanism of action of LGG in improving IBD, providing theoretical support for its clinical application.
The association of the normal range of urinary albumin and its associated diseases (mainly including diabetic kidney diseases, diabetic retinopathy, cardiovascular disease, and metabolic syndrome) has been an increasing concern, and the range of normal urinary albumin has been questioned by a growing number of scholars. We reviewed the association of the normal range of urinary albumin with the aforementioned diseases and the possible mechanism of actions, to assess the value of normal-range urinary albumin as a predictor of the diseases, and to provide a basis for future redefinition of the threshold for the normal range of urine albumin.
Heart failure with preserved ejection fraction (HFpEF) is a common type of heart failure (HF) , and previous treatments that primarily target heart failure with reduced ejection fraction (HFrEF) do not benefit the patients with HFpEF because of the differences in their pathophysiological mechanisms, resulting in high mortality and poor prognosis. Whereas depression is one of the most common mental and psychological problems, caused by various reasons and characterized by a pronounced and long-lasting low spirits, with various degrees of cognitive and behavioral changes. Those who are severely ill even present self-injurious and suicidal behavior. With intensive research into HFpEF, it has emerged that depression has become one of the most common comorbidities in HFpEF and that the two interact to contribute to poor prognosis for patients. Currently, relevant studies in HFpEF with depression suggested that some drugs could improve short term symptoms and clinical prognosis in such patients. This paper aimed to review the comorbid mechanism, research status and the latest progress of related treatment of HFpEF complicated with depression. It is found that sodium glucose cotransporter 2 (SGLT2) inhibitors, angiotensin receptor enkephalinase inhibitors (ARNI) and statin drugs play important roles in the field of HF and psychophysiology. They can not only improve the cardiac function and prognosis of HFpEF patients, but also have the effect of anti-depression, thus to provide references for clinical study and treatment.
Sleep-disordered breathing (SDB) occurs frequently in neuromuscular disease (NMD) patients, and early diagnosis and treatment of which are of great value in the management of NMD. We reviewed the advances in pathogenesis, clinical manifestations, diagnostic and treatment modalities of SDB in NMD. It is noteworthy that although the development of portable sleep monitoring devices is ongoing, the diagnostic value of them for such patients has not been fully clarified, and more attention and further research are still needed.
The human health damage and social stability caused by public health emergencies have attracted worldwide attention. But there is a lack of research on capacity evaluation of China's community emergency preparedness and response for public health emergencies. We summarized the latest advances in theoretical frameworks and capacity evaluation of community emergency preparedness and response for public health emergencies based on a systematic review and textual analysis of relevant studies, and proposed that future research should pay attention to the building of the capacity of community emergency preparedness and response for public health emergencies and the development of corresponding assessment tools applicable to communities in China. This study will contribute to the assessment, normalization and improvement of the capacity of community emergency preparedness and response for public health emergencies.
Intimate partner violence (IPV) refers to the occurrence of threatening or abusive behaviors between intimate partners; the specific forms of which include physical, mental, or sexual injuries. Existing studies have shown that IPV can bring a series of physical and psychological injuries to victims, which seriously affect the victims' quality of life. Accurate assessment of IPV is a prerequisite and fundamental to the formulation of targeted preventive measures. However, domestic research on IPV is still in its infancy, and assessment tools for IPV are lacking. In this paper, we divided eight IPV assessment tools commonly used abroad into research tools and screening tools, reviewed the main contents, applications and characteristics of each tool, and compared the advantages and disadvantages of these eight assessment tools, aiming to provide reference for IPV related research practices in China and a basis for accurately assessing and identifying IPV victims.
The wide application of lung CT scan and lung cancer screening significnatly improves the detection rate of multiple primary lung cancer (MPLC) , namely, lung cancer patients have two or more primaries at the same time. It is a tough problem all the time that how to distinguish between MPLC and intrapulmonary metastases (IM) . Although histological feature analysis is a good means to distinguish them in some circumstances, molecular analysis is also needed generally. Such as the application of next generation sequencing (NGS) is useful for the distinguish between MPLC and IM. For MPLC, surgery remains the main treatment modality. For inoperable MPLC, radiotherapy and local ablation are important treatments. NGS and new therapies such as targeted drug therapy and immune checkpoint inhibitors have become new altenatives for the diagnosis and treatment of MPLC. This article reviews recent advances in the diagnosis and treatment of MPLC.
Exercise has been confirmed by most studies to be effective in preventing and treating depression, and has become a recommended treatment by many researchers. However, previous research results on exercise interventions for depression have not been effectively integrated, and there is still a lack of uniform clinical exercise therapy guidelines across countries. In this paper, we systematically and comprehensively discussed the effects of exercise on depression, including the effects of exercise types, intensities, frequencies, and amounts of exercise on the efficacy of depression interventions in different populations, and summarized the neurobiological mechanisms involved in the development of depression as well as the antidepressant effects of exercise by sorting out relevant literature. This paper shows that in exercise interventions for depression, aerobic exercise is the most frequently chosen type of exercise, the intensity of which is usually moderate to high intensity, and the frequency and amount of exercise are recommended at high frequency and dosage. The neurobiological mechanisms of exercise resistance to depression are mainly that exercise can improve the morphological structure of central nervous system tissue, increase the levels of a series of neurotrophic factors, thereby enhancing neuronal plasticity, and improve the function of the neurosecretory system, reducing damage to brain tissue caused by neuroinflammatory responses and oxidative stress. This paper can provide a certain reference for the development and implementation of clinical exercise prescription for depression in China, and draw on the in-depth development of exercise antidepressant research.
Motivation impairment is highly valued in the treatment and functional rehabilitation of schizophrenia as it is a core symptom of the illness. Although new developments have been made in motivation impairment, but its associated factors are not entirely clear. We reviewed recent studies in motivational impairment in schizophrenia, and made a detailed summary of the features, assessment, and associated factors of motivational impairment, providing ideas for the development of strategies for clinical intervention of schizophrenia.
Schizophrenia is a severe mental disorder that endangers patients and their families' lives as well as the society. Over 80% of patients cannot be cured completely, one contributor to which is patients' lack of self-determined motivation for treatment. There are few studies on self-determined motivation for treatment among patients with schizophrenia in China. Self-determined motivation facilitates the development of positive emotions, behaviors and cognition, which also plays a vital role in the promotion health-related behaviors. We reviewed the latest advances in self-determined motivation towards rehabilitation treatment in schizophrenia patients, and gave a summary of the features and measurement methods regarding self-determined motivation, as well as its roles in predicting the effect of cognitive remediation, physical therapy and other types of rehabilitation treatment, and in maintaining treatment adherence. After that, we made suggestions on the problems to be solved. To improve treatment adherence and cure rate in schizophrenia patients, future studies may focus on developing appropriate interventions in accordance with the self-determined motivation of the patients.
Sodium-glucose-cotransporter-2 (SGLT2) inhibitors originally developed as hypoglycemic agents, have been shown to reduce type 2 atherosclerotic cardiovascular disease (ASCVD) with or without heart failure hospitalization (HFH) and cardiovascular mortality risk in patients with diabetes mellitus (T2DM) . The just-concluded EMPEROR-Preserved trial evaluated the clinical efficacy of an SGLT2 inhibitor (empagliflozin) in patients with heart failure with preserved ejection fraction (HFpEF) and the results showed that its clinical effect could be further extended to heart failure mildly reduced ejection fraction (HFmrEF) patients. Although SGLT2 inhibitors have ushered in a new era of reducing HF incidence and preventing HF exacerbation, the search for key mechanisms by which SGLT2 inhibitors improve symptoms should continue to protect heart failure patients from the fatal progression of heart failure disease. This paper reviews the application of SGLT2 inhibitors in the treatment of HFmrEF patients, in order to provide theoretical guidance for the treatment of HFmrEF patients.
At present, there are many types of drugs for clinical treatment of type 2 diabetes mellitus (T2DM) , there are differences in the hypoglycemic mechanisms and safety of traditional hypoglycemic drugs such as thiazolidinediones, sulfonylureas, biguanides, and insulin. In recent years, an assortment of new target drugs has emerged in an endless stream.New target drugs such as glucokinase activators, multi-site receptor agonists for GLP-1, GIP and glucagon, glucagon receptor inhibitors have gradually assembled the necessities of personalized clinical treatment through different mechanisms. This article reviews the current research progress of new target drugs for T2DM, and analyzes the advantages and disadvantages of clinical research of various new target drugs, in order to provide basic guidance for the clinical treatment of T2DM.
Hypomimia is one prominent clinical symptom of Parkinson's disease (PD) , which is mainly characterized by a loss or reduction of voluntary, emotional and other facial expressions, and usually appears bilaterally and symmetrically. Factors associated with hypomimia in PD have been extensively studied recently, including basal ganglia dysfunction, facial emotion recognition deficit, and cognitive impairment, but the specific pathophysiological mechanism is still unclear. Hypomimia strongly correlates with the progression of PD, so scientific quantification and evaluation of hypomimia will be of great significance to the diagnosis and treatment of PD. Besides that, there is still controversy over its treatment plan. We reviewed the latest developments in clinical presentations, pathogenesis and treatment of hypomimia in PD.
Aging has become a global issue. Due to skin aging, coexistence of multiple chronic diseases, disability and semi-disability, older people are prone to various skin injuries, such as pressure injury, moisture-associated skin damage, skin tear, dry skin. These skin injuries may be single or multiple, and multiple types of injuries may coexist, which impair the quality of life and even threaten the life. Skin health in older people has become a global focus, and the prevention of which has been regarded as a priority in clinical nursing and management. We reviewed recent advances in the epidemiology, types and prevention of skin injuries in older adults, providing a reference for the prevention and management of skin injuries in older Chinese adults.
Current Status of PD-1/PD-L1 Anti-tumor Therapy and Exploration of the Mechanism of Immune-related Adverse Events
Programmed cell death protein-1 (PD-1) and programmed death ligand 1 (PD-L1) inhibitors are a group of immune checkpoint inhibitors. Since May 2006, there have been 10 immune checkpoint inhibitors targeting PD-1 and PD-L1 for tumor treatment. Although PD-1/PD-L1 inhibitors show promising curative effects on certain tumors, serious immune-related adverse events limited the clinical application. Therefore, it is urgent to develop new drugs with the same efficacy but fewer side effects than PD-1/PD-L1 inhibitors. In addition, exploring the mechanisms of immune-related adverse events provides a scientific foundation for developing personalized intervention strategies, which is equally important in the research of PD-1/PD-L1 inhibitors. This review discusses the mechanism and immune-related adverse events of several anti-PD-1/PD-L1 monoclonal antibodies, aiming at reminding clinicians of the occurrence of related adverse events while performing anti-tumor therapy. Moreover, this review also points out the possible research direction of PD-1/PD-L1 inhibitors in the future.
Research Advances in Vestibular Rehabilitation Mechanism and Treatment
Recent years have seen rapid advances in clinical diagnosis and treatment of vestibular diseases, especially vestibular evaluation and rehabilitation technologies, greatly promoting the developments in individualization and precision of rehabilitation for peripheral and central vestibular diseases. The vestibular rehabilitation helps to correct inappropriate strategy of equilibrium and/or to accelerate a good but slow compensation phenomenon, effectively improve vestibular, visual, and proprioceptive inputs to balance coordination control ability, improve the compensatory function of central nervous system, so as to reduce or eliminate the symptoms of dizziness, vertigo, and balance instability, eventually restoring the normal vestibular status. Given this background, we reviewed the advances in mechanisms of rehabilitation, pre-rehabilitation evaluation, rehabilitation program formulation and treatment regarding vestibular diseases, offering insights into clinical implementation and research concerning vestibular rehabilitation in China.
Research Progress on the Relationship between Osteoporosis and Cognitive Impairment
In recent years, studies have shown that among elderly comorbidities, the incidence of comorbidity between osteoporosis and cognitive impairment is increasing year by year, which is manifested as a high incidence of falls and an increased risk of fractures, which leads to disability, increased mortality, and serious harm to health and quality of life of patients with comorbidities also bring a heavy economic burden to the family and society, which has become a more difficult problem in the management of chronic diseases in the community. This article reviews the progress of the relationship between osteoporosis and cognitive impairment. The focus is on the co-morbidity mechanism, clinical risk factors and clinical features of co-morbidity between osteoporosis and cognitive impairment. It is found that osteoporosis is closely related to cognitive impairment and seriously endangers the health of the elderly. It is hoped that this article can provide ideas for exploring new risk factors for comorbidity of osteoporosis and cognitive impairment, and provide help for the effective prevention and management of patients with comorbidity of osteoporosis and cognitive impairment.
The Janus kinase/signal transducer and activator of transcription (JAK/STAT) signaling pathway is a ubiquitously expressed intracellular signal transduction pathway involved in cell proliferation, differentiation, apoptosis, immune regulation and other biological processes. Existing evidence indicates that continuous activation of this signaling pathway is closely related to the pathogenesis and clinical manifestations of many autoimmune rheumatic diseases. We reviewed the latest advances in mechanisms of JAK/STAT signal transduction, and the roles of the pathway in development of autoimmune rheumatic diseases such as rheumatoid arthritis, systemic lupus erythematosus, and gout, suggesting that JAK/STAT signaling pathway may be a therapeutic target for autoimmune rheumatic diseases, which may offer new ideas and directions for clinical treatment.
Cushing's disease is caused by excessive secretion of adrenocorticotropic hormone (ACTH) by hormone-secreting pituitary adenomas, the first-choice treatment for which is surgical resection of the pituitary adenoma. Medication therapy is the second-line treatment, and a necessary treatment for some patients with unsatisfactory surgical results or failing to use the surgery. With recent developments in pathogenesis studies of Cushing's disease, medications specifically targeting hormone-secreting pituitary adenomas have proven to be effective in controlling the tumor growth, and suppressing the tumor's secretion of ACTH, which may be a theoretical and practical basis for medical treatment of Cushing's disease. In this review, we discussed pituitary-directed medical therapies for Cushing's disease and their mechanisms of actions, aiming to increase medical workers' understanding of this disease, and to offer theoretical evidence for the development of appropriate treatment strategies.
As the most common autoimmune thyroid disease, Hashimoto's thyroiditis (HT) is also the primary cause of hypothyroidism, leading to increased risk of mental diseases, and even myxedema and coma. However, there are few studies on clinical treatments for HT. Thyroid autoantibodies produced in serum due to autoimmune disorders, may be significantly involved in the diagnosis and prognosis of HT. Evidence has suggested that the controlling for the intake of nutrient elements (such as appropriate selenium supplementation and iodine intake) may improve thyroid function by notably reducing the thyroid autoantibody titer, indicating the treatment may be positive in treating HT. But the correlations of various nutritional factors with HT treatment are still controversial. We reviewed recent developments in the treatment of HT, then summarized the influence of controlling for the intake of various nutritional factors (such as selenium, iodine, iron and vitamin D) on the treatment of HT, and concluded that the controlling may help to reduce thyroid autoantibody titers, and improve the therapeutic effect, and may be a reference for clinical treatment of HT.
Drug-induced lung injury has received more and more attention. The most common pattern is interstitial lung disease. The diagnosis, treatment and prognosis of drug-induced interstitial lung disease (DIILD) have been explored in many researches. However, there are still many subtypes of DIILD, including usual interstitial pneumonia, non-specific interstitial pneumonia, organizing pneumonia, hypersensitivity pneumonia and diffuse alveolar damage depending on the pathology. Each subtype may be different in treatment and management and further clarification is needed. This paper focused on the common subcategory of organizing pneumonia, naming it as drug-induced organizing pneumonia (DIOP) , explored the most common anticancer drugs, understood the potential mechanism of anticancer drugs to cause OP, and explored the diagnosis, differential diagnosis, treatment and prognosis of DIOP, so as to make a better guide on the diagnosis and treatment of organizing pneumonia induced by anticancer drugs.
The development of cancer is an evolving process, with proliferation, invasion and metastasis as basic biological features. As a new class of actin regulatory proteins, Wiskott-aldrich syndrome protein (WASP) family is a key component in maintaining the basic morphology of actin cytoskeleton that is involved in many essential processes including maintaining basic structure of cells, and cell motility and signaling. It also mediates the proliferation, invasion and metastasis of cancer cells. We reviewed latest advances in the role of WASP family in cancer formation and progression, its expression levels in different cancers and related signaling pathways, suggesting that relevant research is highly promising, and reflecting the importance of WASP family in mechanisms of carcinogenesis, cancer treatment and prognosis prediction.
Research Progress of the Prevention and Treatment of Metabolic Diseases Based on Short Chain Fatty Acids
Short chain fatty acids (SCFAs) are a class of saturated fatty acids containing 1-6 carbon atoms, which are mainly produced by specific flora in the intestine through the fermentation of dietary fiber, and play an important role in maintaining the homeostasis of the intestinal environment. Recent studies have shown that SCFAs can regulate glucose and lipid metabolism, regulate energy balance, maintain the intestinal barrier and reduce inflammatory responses, eventually participating in the occurrence and development of metabolic diseases such as type 2 diabetes mellitus, obesity, lipid metabolic disorders and nonalcoholic fat liver disease through the above multiple pathways. This article summarizes the mechanism of SCFAs regulating metabolism and the research progress in the prevention and treatment of metabolic diseases, in order to provide more reference materials for the prevention and treatment of metabolic diseases.
Recent Developments in the Prevention and Treatment of Irritable Bowel Syndrome
Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disease. The clinical symptoms of IBS mainly include abdominal pain and abnormal bowel movements. Clinically, IBS is divided into four types, which are caused by environmental and host factors, but the exact pathogenesis is unclear. Clinical diagnosis, treatment, and prevention of IBS are rather tricky. In contrast to functional diarrhea and constipation, the most notable symptom for diagnosing IBS is abdominal pain. The treatments for IBS include non-drug treatment and/or drug treatment. In general, the non-drug treatment is delivered in accordance with the patient's physiology and psychology, including professional guidance, dietary intervention, and psychological counseling. And drug treatment is implemented depending on the specific condition of the patient. Recent studies have shown that the intestinal flora is also involved in the incidence and progression of IBS, and the use of probiotics and intestinal microbiota transplantation may be effective treatments for IBS. This article reviews the latest developments in pathogenesis, treatments, prevention strategies, and possible future research directions regarding IBS.
Recent Advances in Return-to-work Self-efficacy Assessment Tools
Returning to work is an important sign of recovery and returning to normal life for patients. Most patients have a strong desire to return to work, however, their confidence is low. Return-to-work self-efficacy is not only a reflection of patients' confidence in returning to work but also an important predictor of his readiness to get back to work. Based on the concept and meaning of return-to-work self-efficacy, this study introduces its related theoretical models, summarizes the contents, scoring criteria, validity and reliability of related assessment tools, and conducts a comparative analysis of the tools, to provide Chinese rehabilitation care workers with evidence contributing to the selection of an appropriate return-to-work self-efficacy assessment tool.
Recent Advances in Evaluation Tools and Associated Factors for Patient Delay in Chronic Disease Patients
Patient delay will lead to increased risk of complications, reduced treatment effectiveness and lowered quality of life in chronic disease patients. Early identifying individuals with chronic diseases at high risk of patient delay, and timely delivering targeted interventions to them may greatly improve current status of patient delay in this population. Based on a literature review, we systematically summarized several major evaluation tools (including Barriers to Access to Care Evaluation scale, Perceived Barriers to Health Care-seeking Decision, Stroke Pre-Hospital Delay Behavior Intention scale, Diabetes Mellitus Diagnosis and Treatment Delayed Cognitive Behavioral Intention Scale, and Attitudes toward Medical Help-seeking Scale developed by Fisher et al.) for patient delay in chronic disease patients, and analyzed controllable (mental and cognitive) and uncontrollable (sociodemographic and disease-specific) factors associated with patient delay, offering evidence for the assessment of patient delay and development of relevant interventions. We found that the applicability and clinical application rate of these tools are low, and their predictive efficacy and threshold have been rarely studied, and patient delay may be significantly associated with patients' insufficient knowledge of the disease, low economic level and low social support.
New Developments in Biotargeted Drug Therapies for Glucocorticoid-induced Osteoporosis
Glucocorticoid-induced osteoporosis (GIOP) is the most common form of secondary osteoporosis, but its treatment is challenging, which may be due to lack of focus. Recent years have seen considerable developments in biotargeted therapies targeting two important pathophysiologic mechanisms for treating GIOP, including increased osteoclast activities induced by receptor activator of nuclear factor-κB ligand and decreased bone formation induced by inhibition of Wnt signaling pathway. We summarized the latest advances in three biotargeted drugs, denosumab, sclerostin monoclonal antibody and DKK-1 monoclonal antibody, in the treatment of GIOP, and found that denosumab can significantly increase bone mineral density of patients with GIOP, and sclerostin monoclonal antibody and DKK-1 monoclonal antibody are new promising therapies for GIOP. However, due to limited evidence, efficacies of these biotargeted drugs in GIOP need to be studied further.
